Hi Cheryl,

My intent was not to direct my post to you but more generally that each patient has to deal with the realities of their care system, that is all.

I know everyone here wants to and strives to be as helpful as possible. However, I think there is not much realistic benefit by bringing up NCI or NCCN guidelines to someone in the India care system.

I am certain India and other countries have their own set of established or maybe adapted/adopted other medical guidelines and the doctors are probably not only inclined but bound to follow that set.

Sure, the King of Saudi Arabia gets on a plane and gets medical care in the USA but not many have such an option and have to receive care that is available to them; often times at a much lower standard than here in the developed world.

I'm just saying it's great to point out what is available and works to all but there is no need to nudge, cagole, or overly encourage those to seek care beyond their means. Rather, support their effort to seek the best care they can obtain.

We all care a lot so we want the very best outcomes for all but the reality is many will never be able to obtain the very best outcomes, even all here in the USA do not achieve it.